1. Anatomical and functional outcomes following switching from aflibercept to ranibizumab in neovascular age-related macular degeneration in Europe: SAFARI study
- Author
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David Gilmour, Ian Pearce, Deepali Varma, Konstantinos Balaskas, Susan M. Downes, Faruque Ghanchi, Franklin Igwe, Frank G. Holz, Haralabos Eleftheriadis, Nishal Patel, C Santiago, Robin Hamilton, Steffen Schmitz-Valckenberg, Richard Gale, Priya Prakash, Saju Thomas, Andrew J. Lotery, Filis Ayan, Ben J L Burton, Michael Williams, Armin Wolf, Nicole Eter, Rosina H Zakri, Sheena George, and Gavin Walters
- Subjects
Male ,Vascular Endothelial Growth Factor A ,Visual acuity ,genetic structures ,Visual Acuity ,degeneration ,Angiogenesis Inhibitors ,neovascularisation ,0302 clinical medicine ,Pro re nata ,Germany ,Clinical endpoint ,Single-Blind Method ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Aflibercept ,Aged, 80 and over ,education.field_of_study ,Drug Substitution ,imaging ,clinical trial ,Middle Aged ,Clinical Science ,Sensory Systems ,Intravitreal Injections ,Female ,medicine.symptom ,medicine.drug ,medicine.medical_specialty ,Recombinant Fusion Proteins ,Population ,Retina ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,SDG 3 - Good Health and Well-being ,Ophthalmology ,Ranibizumab ,medicine ,Humans ,macula ,education ,Aged ,business.industry ,Macular degeneration ,medicine.disease ,Choroidal Neovascularization ,United Kingdom ,Receptors, Vascular Endothelial Growth Factor ,030221 ophthalmology & optometry ,Wet Macular Degeneration ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Background/AimsProspective data on switching anti-vascular endothelial growth factors in patients with neovascular age-related macular degeneration (nAMD) who have previously shown no/partial response are limited. This prospective study assessed the effect of switching from aflibercept to ranibizumab on anatomical and functional outcomes in patients with persistent/recurrent disease activity.MethodsSAFARI (NCT02161575) was a 6-month, prospective, single-arm study conducted in the UK and Germany. Patients, meeting strict eligibility criteria for one of two subgroups (primary treatment failure or suboptimal treatment response), received 3 monthly intravitreal ranibizumab injections (0.5 mg). Thereafter, ranibizumab was administered pro re nata at monthly visits. The primary endpoint was change from baseline (CfB) to day 90 in central subfield retinal thickness (CSRT). Best-corrected visual acuity (BCVA) and retinal morphology parameters were assessed.ResultsOne hundred patients were enrolled (primary treatment failure, 1; suboptimal treatment response, 99). In the overall population, there was a significant CfB in median CSRT of −30.75 µm (95% CI −59.50,–20.50; pConclusionSwitching from aflibercept to ranibizumab led to a significant improvement in CSRT, with ~60% experiencing stabilised/improved BCVA. Therefore, patients with nAMD who have shown a suboptimal response to aflibercept may benefit from switching to ranibizumab.
- Published
- 2019
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